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Please read this information carefully before you decide about using this method of contraception.
It provides you with some useful information about Mirena.
The information on this page applies only to the Mirena. If you have any questions or are not sure about anything, please ask your doctor, nurse or clinic.
It consists of a small T-shaped frame made from a plastic called Polyethylene. This carries 52 milligrams of levonorgestrel, a hormone used in many contraceptive pills. The hormone is contained within a substance called polydimethylsiloxane. This is surrounded by a membrane (skin) also made of polydimethylsiloxane.
The T-shaped frame also contains barium sulphate so that it can be seen on X-rays.
This structure provides a system for releasing the hormone gradually into the uterus (womb).
There are two fine threads, made of iron oxide and polyethylene, attached to the bottom of the frame. These allow east removal and allow you or your doctor to check that the system is in place.
Mirena is an effective, long-term and reversable method of contraception. It is placed inside the uterus where it slowly releases the hormone over a period of 5 years or until it is removed.
The hormone in Mirena prevents pregnancy by: * controlling the monthly development of the uterus lining so that it is not thick enough for you to become pregnant. * makingthe normal mucus in the cervix canal (opening to the uterus) thicker, so that the sperm cannot get through to fertilise the egg. * preventing ovulation (the release of egg) in some women.
* there are also local effects on the lining of the uterus caused by the presence of the T-shaped frame.
Not all women should use Mirena
Tell your doctor:
* if you are sensitive to the hormone levonorgestrel or to any of the ingredients in Mirena.
* if you are pregnant, suspect that you are pregnant or are breast feeding.
* if you have an unusual vaginal bleeding pattern.
* if you have any unusual or unpleasent vaginal discharge, or vaginal itching.
* if you have or had pelvic inflammatory disease.
* if you have had inflammation of the lining of your uterus following delivery of your baby.
* if you have or have had and infection of the uterus after delivery or after abortion during the past 3 months.
* if you have or have had inflammation of the cervix (neck of the cervix).
* if you have or have had an abnormal smear test (changes in the cervix).
* if you have had a stroke, heart attack or any heart problems.
* if you have or had liver problems.
* if you have any condition which makes you susceptible to infection. A doctor will have told you if you have this.
* if you have or have had and type of cancer, suspected cancer or leukaemia.
* if you have or have had trophoblastic disease. A doctor will have told you if you have this.
* if you are diabetic, have high blood pressure or abnormal blood lipid levels.
* if you have fits (epilepsy).
* if you have a history of blood clots (thrombosis).
* if you are on long-term steroid therapy.
* if you are taking any other medicines as some medicines may stop Mirena from working properly.
* if you have or develop migraine, dizziness, blurred vission, unusually bad headaches or you have headache more often than before.
* if you have ever had an ectopic pregnancy or a history of ovarian cycts.
You may still be able to use Mirena if you have had some of these conditions. Your doctor or clinic will advise you.
It is advisable to give up smoking.
If you want a baby, ask your doctor to remove Mirena. Your usual level of fertility will return very quickly after the system is removed.
Very small amounts of the hormone in Mirena are found in breast milk. If you want to breast feed your baby, you should discuss this with your doctor.
It is very rare for women to become pregnant with Mirena in place.
Missing a period may not mean that you are pregnant. Some women may not have periods while using the system.
If you have not had a period for 6 weeks then consider having a pregnancy test. If this is negative there is no need to carry out another test, unless you have other signs of pregnancy, e.g sickness, tiredness or breast tenderness.
However, if you become pregnant with the system in place you should have it removed as soon as possible. You might want to consider having an abortion. Your doctor or clinic will advise you.
Only a doctor or specially trained nurse can fit the system.
They will:
* give you a pelvis examination to find the possition and size of the uterus.
* place a speculum (an instrument to help the doctor see the cervix) into the virgina.
* clean your virginal and cervix.
* place a thin flexable tube containg the system into your vagina and then through the cervix into the uterus. (At this point you may feel a little discomfort).
* withdraw the tube leaving the system in place.
* trim the threads to a suitable length for easy removal.
The system should be inserted either during your period or within seven days from the beginning of you period. If you lready have the system and it is time to replce it with a new one, you do not need to wait until your period. If you have just had a baby, you should wait at least 6 weeks before having Mirena fitted. Mirena can sometimes be fitted immediatly after you have had an abortion, provided that you have no genital infections.
If you have epilepsy, tell the doctor or nurse fitting the Mirena because, although rare, a seizure (fit) can occur during insertion. Some women might feel faint after the system is fitted. This is normal and your doctor will tell you to rest for a while. In very rare cases during fitting, part or all of the system could penetrate the wall of the uterus. If this happens the system is removed.
You are protected from pregnancy as soon as the system is fitted.
You should have the system checked usually 6 weeks after it is fitted, again at 12 months and then once a year until it is removed. It can stay in place for 5 years.
If the system comes out either completly or partally you may not be protected against pregnancy.
It is rare but possible for this to happen without you noticing during menstrual period. An unusual increase in the amount of bleeding during your period might be a sign that this has happened. Tell you doctor or clinic if there are any unexpected changes in your bleeding pattern.
After each menstrual period, you can feel for the two thin threads attached to the lower end of the system. Your doctor will show you how to do this.
Do not pull the threads because you may accidentally pull it out. If you cannot feel the threads, go to your doctor.
You should also go to your doctor if you feel the lower end of the system itself or you or your partner feel pain or discomfort during sexual intercourse.
Your doctor can remove the system at any time. The removal is very easy. Unless you plan to have a new system or an intruterine device fitted immediatly, it is important to use another form of contraception in the week leading up to the removal. Intercourse during this week could lead to pregnancy after Mirena is removed.
Mirena will affect your menstrual cycle. You might experience spotting, shorter or longer periods, painful periods, lighter periods or no periods at all.
Many women have spotting (a small amount of blood loss) for the first 3-6 months after the system is fitted. Others will have prolonged or heavy bleeding. Overall you are likely to have fewer days bleeding in each month and you might eventually have no periods at all. This is due to the effect of the hormone (levonorgestrel) on the lining of the uterus.
Taking any medicines carries some risk of side effects. With Mirena these are most common during the first months after the system is fitted and dcrease as time goes on. Apart from menstrual changes, possible side-effects might include headache, lower adbominal or back pain, acne or other shin problems, tender, lump breasts, increase discharge from the vagina, virginal itching or pain on passing urine, depression or other mood changes, a feeling of sickness, or swelling of thelegs and ankles. Overian cysts and pelvic imflammatory disease abdominal pain or if you experience painful or difficulty sex. Other side-effects such as weight gain, hair loss or greasy hair have been rarely reported.
Ectopic pregnancy (development of a fetillised egg outside the uteru) is possible with Mirena but highly unlikely. The risk of this happening is lower than for women using no contracetion.
You should tell your doctor if you have lower adbominal (tummy) pain especially if you also have a fever or have missed a period or have unexpected bleeding. This might be a sign of ectopic pregnancy.
If you think you are reacting badly to Mirena or having any other problems, please tell your doctor or clinic.
My Comment:
I know gynaecologist's wont like me placing this information on my website, but all the information above is typed up from the "Mirena Coil - Patient Information Booklet" which I was handed to me in 'September 2000'. I didn't know anything about the Mirena Coil until after I had it inserted and my gynaecologist handed me the leaflet afterwards.
I believe that patients should know about there treatment before having it and not afterwards (like I had), when its nice to read up on there treatment before hand and not afterwards.
I hope this information helps a lot of women out there who have / considering having the Mirena Coil fitted.
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